Individual provider Active NPI

Chandler H Christophe

  • Family Medicine Physician
  • Boston, MA
National Provider Identifier
1053773515
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
279351 Issued in MA
Practice address
1 Boston Medical Ctr PL
Dowling 5 South
Boston, MA 02118-2908
Phone
(617) 414-4465
Fax
(617) 414-3345
NPI assigned
Mar 24, 2016
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 279351 MA Primary

Addresses

Primary practice location

1 Boston Medical Ctr PL
Dowling 5 South
Boston, MA 02118-2908

Mailing address

801 Albany St FL Ground
Boston, MA 02119-2908
Phone (617) 414-5405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191104002108 MA Practitioner - Family Practice 5890080436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers New Jersey Medical School, 2016
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1575 Blue Hill Ave
Boston, MA 02126-2122
Phone (617) 296-0061

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
279351MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mattapan Community Health Center Inc CurrentSince Nov 1, 2019 Accepting new patients
Mattapan Community Health Center Inc Past Accepting new patients

Locations

1575 Blue Hill Ave
Mattapan, MA 02126
Phone (617) 296-0061

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1053773515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST FL GROUND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021192908",
            "telephone_number": "617-414-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOSTON MEDICAL CTR PL",
            "address_2": "DOWLING 5 SOUTH",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182908",
            "telephone_number": "617-414-4465",
            "fax_number": "617-414-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHE",
        "first_name": "CHANDLER",
        "middle_name": "H",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "279351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.